AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2690-8794/089
*Corresponding Author: Gian Maria Pacifici, Associate Professor of Pharmacology, via Sant’Andrea 32, 56127 Pisa, Italy.
Citation: Gian M. Pacifici, (2021) Clinical pharmacology of teicoplanin in infants and childrenJ, Clinical Medical Reviews and Reports. 3(6); DOI:10.31579/2690-8794/089
Copyright: © 2021, Gian Maria Pacifici, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 03 June 2021 | Accepted: 21 June 2021 | Published: 13 August 2021
Keywords: teicoplanin, dosing, efficacy, safety, pharmacokinetic, treatment, cerebrospinal fluid, infants, children
Teicoplanin is a glycopeptide and is a mixture of related glycopeptides. Teicoplanin inhibits the synthesis of the cell wall in sensitive bacteria by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria. The intravenous dosage of teicoplanin consists in a loading dose of 16 mg/kg followed by a maintenance dose of 8 mg/kg once-daily to infants aged < one month and in older infants the dosage of teicoplanin consists in a loading dose of 12 mg/kg twice-daily followed by a maintenance dose of 10 mg/kg once daily. In children, the oral dose is 100 to 200 mg twice-daily and the intravenous dosage consists in 12 mg/kg twice-daily followed by 12 mg/kg once-daily. Teicoplanin has been found efficacy and safe in infants and children. The elimination half-life of teicoplanin is 73.9 hours in infants and children and teicoplanin is cleared from the body by renal and extra-renal routes. The total body clearance of teicoplanin is 0.09 L/h in children aged < 12 months and 0.29 L/h in older children. The treatment and the prophylaxis with teicoplanin have been described in infants and children. Teicoplanin administered intravenously and/or intraventricularly treats the cerebral infections caused by staphylococci and enterococci. The aim of this study is to review the published data on teicoplanin dosing, efficacy and safety, pharmacokinetics, drug-interactions, treatment, prophylaxis, and penetrates into the cerebrospinal fluid in infants and children.
Teicoplanin is a glycopeptide and is a mixture of related glycopeptides. It is similar to vancomycin in chemical structure, mechanism of action, spectrum of activity, and route of elimination which is primarily renal [1].
Mechanism of action of teicoplanin
Teicoplanin inhibits the synthesis of the cell wall in sensitive bacteria by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria [1].
Absorption, distribution metabolism and elimination of teicoplanin
Teicoplanin may be administered by intramuscular injection as well as by intravenous administration. An intravenous dose of 1 gram in adults produces plasma concentrations of 15 to 30 µg/ml 1 hour after 1 to 2 hours of infusion. Teicoplanin is highly bound by plasma proteins (90 to 95%) and has extremely long serum elimination; the half-life is up to 100 hours allowing for once-daily dosing. Excretion is though glomerular filtration [1].
Literature search
The literature search was performed electronically using PubMed database as search engine and the following key words were used: “teicoplanin dosing infants, children“, teicoplanin efficacy, safety infants, children”, “teicoplanin pharmacokinetics infants, children”, “drug-interactions”, “teicoplanin treatment infants, children”, “teicoplanin prophylaxis infants, children”, and “teicoplanin penetration into the cerebrospinal fluid”. In addition, the books: The Pharmacological Basis of Therapeutics [1], Neonatal Formulary [2], and The British National Formulary for Children [3] were consulted.
Dosing schedules of teicoplanin in infants and children
Intravenous administration to infants [2]
Infants aged < one> Give: 16 mg/kg loading dose by intravenous injection followed by an intravenous or intramuscular maintenance dose of 8 mg/kg once-daily. Double the dosage interval in infants with renal failure.
Older infants. Give: 10 mg/kg twice-daily intravenously followed by a maintenance dose of 10 mg/kg once-daily.
Oral or intravenous administration to children [3]
Oral treatment of clostridium difficile
Children aged 12 to 17 years. Give: 100 to 200 mg twice-daily for 7 to 14 days.
Intravenous or intramuscular administration for serious infections caused by gram-positive bacteria (e.g., complicated skin, soft-tissue infections, pneumonia, and complicated urinary-tract infections)
Children aged 12 to 17 years. Give: initially 12 mg/kg twice-daily for 3 to 5 days followed by a maintenance dose of 12 mg/kg once-daily.
Intravenous administration for serious infections caused by gram-positive bacteria (including endocarditis, complicated skin and soft-tissue infections, pneumonia, complicated urinary-tract infections, bone, and joint infections)
Children aged 1 month. Give: initially 16 mg/kg for 1 dose, followed by a maintenance dose of 8 mg/kg once-daily.
Children aged 2 months to 11 years. Give: initially 10 mg/kg twice-daily for 3 doses, followed by a maintenance dose of 6 to 10 mg/kg once-daily.
Efficacy and safety of teicoplanin in infants and children
Teicoplanin has been found efficacy and safe in treating infants with staphylococcal sepsis [4]. Teicoplanin and vancomycin are equally effective in treating bacterial infections; however the incidence of nephrotoxicity and other adverse-effects are lower with teicoplanin. It may be reasonable to consider teicoplanin for children at higher risk for acute kidney injury [5]. While vancomycin and teicoplanin exhibit equal clinical and microbiological efficacy in treating bacteraemia, teicoplanin is less likely to induce allergic reactions or nephrotoxicity in children [6]. The results of the meta-analysis indicate that teicoplanin and vancomycin are similar in both efficacy and safety, thus teicoplanin can act as an effective alternative to vancomycin for treating children infected by methicillin-resistant Staphylococcus aureus [7]. Home treatment of infections with teicoplanin is effective, well tolerated, and offers advantages in terms of quality of life in ill children [8].
Pharmacokinetics of teicoplanin in infants and children
Lukas et al. [9] studied the pharmacokinetics of teicoplanin in 40 infants and children who were aged 37.6+35.4 months and weighed 14.3+6.2 kg. Subjects were randomized to receive either 3 loading doses of teicoplanin intravenously at a dose of 10 mg/kg twice-daily followed by a maintenance dose 10 mg/kg once-daily or the same loading dose followed by a maintenance dose of 15 mg/kg once-daily. Teicoplanin was administered as 1 hour infusion.
K12 = transfer rate constant from the central to peripheral compartment. K21 = transfer rate constant from the peripheral to central compartment.
This table shows that the central distribution volume is larger than the water volume, K12 is greater than K21, and the absorption half-life is smaller than the elimination half-life.
K12 = transfer rate constant from the central to peripheral compartment. K21 = transfer rate constant from the peripheral to central compartment.
aP-value < 0>
Reed et al. [10] investigated the pharmacokinetics of teicoplanin in 12 infants and children aged 6+3.1 years and weighed 21.4+9.3 kg. Each subject received teicoplanin intravenously at a dose of 6 mg/kg once-daily for 5 days. Teicoplanin concentration was measured in the plasma and urine.
This table shows that teicoplanin is eliminated by both the renal route and extra-renal routes.
Ramos-Martín et al. [11] explored the pharmacokinetics of teicoplanin in
39 infants and children aged 4+4.3 years and weighed 17.3+13.3 kg. Teicoplanin was administered intravenously at a dose of 10 mg/kg twice-daily for 3 loading doses followed by a maintenance dose of 10 mg/kg once-daily.
Kcp = first-order rate constant from the central to peripheral compartment. Kpc = first-order rate constant from peripheral to central compartment.
This table shows that the central distribution volume is larger than the water volume. The transfer rate constant from the central to peripheral compartment is similar to the transfer rate constant from the peripheral to central distribution compartment. This observation is in conflict with that reported in tables 1 and 2 where the transfer rate constant from the central to peripheral compartment is greater than the transfer rate constant from the peripheral to central comportment. There is a remarkable interindividual variability in the pharmacokinetic parameters of teicoplanin.
Interaction of teicoplanin with drugs
Teicoplanin co-administered with cefotaxime and ofloxacin has a synergist effect in gram-positive organisms [12]. A synergistic effect is observed with the combination of teicoplanin and netilmicin and amikacin in enterococci and staphylococci [13].
Treatment with teicoplanin in infants and children
Twenty-three preterm infants had the gestational age of 28.4 weeks, the postnatal age ranged from 5 to 47 days, and had a sepsis caused by staphylococci. The infection is cured with teicoplanin loading dose of 15 mg/kg followed by a maintenance dose of 8 mg/kg once-daily [14]. Of twenty-nine children with infections caused by gram-positive organisms 21 children (72.4%) are cured with teicoplanin [15]. Children, aged ≤ 18 years, had an infection caused by gram-positive organisms and are cured with teicoplanin at a dose of 10 mg/kg twice-daily [16]. Children, aged 2 to 12 years, with gram-positive infections are cured with teicoplanin at a dose 10 mg/kg daily [17]. The loading dose of teicoplanin (6 mg/kg twice-daily for at least three doses) must be considered mandatory in all children, regardless of their renal function, to enable optimal drug concentrations to be achieved early in the treatment period [18].
Prophylaxis with teicoplanin in children
Antibiotic prophylaxis with teicoplanin appears safe and feasible and eradicates viridians sepsis and decreases the incidence of febrile neutropenia in paediatric patients with acute myeloid leukaemia [19]. Prophylaxis with teicoplanin is efficacy in preventing Staphylococcal epidermidis in children [20].
Treatment of cerebral infections with intravenous and/or intraventricular teicoplanin
Teicoplanin administered intravenously at a dose of 15 mg/kg daily decreases the staphylococci and enterococci counts in the cerebrospinal fluid from 2.31% to 0.71% 6 hours after dosing, becomes bactericidal 24 hours after treatment, and this treatment does not produce therapeutic failures [21]. Teicoplanin administered intravenously at a dose of 240 mg once-daily and intraventricularly at a dose of 10 mg once-daily treats the staphylococcal ventriculitis and no signs of recurrent infection or adverse-effects were observed [22]. Seven patients with staphylococcal neurosurgical shunt infections were treated with teicoplanin intraventricularly. Two infants received 5 mg daily and five patients received 20 mg daily. Intraventricular administration of teicoplanin produces high and prolonged peak and trough levels of teicoplanin in the cerebrospinal fluid and the bactericidal activity of teicoplanin in the cerebrospinal fluid is remarkable [23]. Three patients had the cerebrospinal fluid infected by Staphylococcus epidermidis and Enterococcus faecalis and were treated with teicoplanin intraventricularly at a dose of 10 to 15 mg daily. Teicoplanin concentrations in the cerebrospinal fluid, 24 hours after intraventricular injection, exceeded 4- to 8-fold the MICs of the infecting organisms and the cerebrospinal fluid cultures rapidly became negative [24]. One patient had the neuro-shunt infected by methicillin-sensitive Staphylococcus epidermidis and two patients had the neuro-shunt infected by methicillin-sensitive Staphylococcus aureus. Teicoplanin was administered intravenously at a dose of 400 mg daily and intraventricularly at a dose of 20 mg daily to the three patients. The therapy clears the infection in one week, the concentration of teicoplanin is 30 to 38 µg/ml (mean 34). Teicoplanin administered intravenously and intraventricularly is well tolerated and does not cause adverse-effects [25].
Teicoplanin is a glycopeptide and is a mixture of related glycopeptides. Teicoplanin inhibits the synthesis of the cell wall in sensitive bacteria by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria [1]. The intravenous dosage of teicoplanin consists in a loading dose 16 mg/kg followed by a maintenance dose of 8 mg/kg once-daily in infants aged < one>
In conclusion, teicoplanin is a glycopeptide and is a mixture of related glycopeptides. Teicoplanin inhibits the synthesis of the cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria. The intravenous dosage of teicoplanin consists in 16 mg/kg loading dose followed by a maintenance dose of 8 mg/kg once-daily to infants aged < one>
The authors declare no conflicts of financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employments, gifts, and honoraria. This article is a review and drugs have not been administered to men or animals.
The author thanks Dr. Patrizia Ciucci and Dr. Francesco Varricchio, of the Medical Library of the University of Pisa, for retrieving the scientific literature.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
